静脉或硬膜外给予绵羊体内后羟考酮的药代动力学和胎儿暴露情况。

Oxycodone pharmacokinetics and fetal exposure after intravenous or epidural administration to the ewe.

机构信息

School of Medicine, University of Eastern Finland, Kuopio, Finland.

Admescope Ltd, Oulu, Finland.

出版信息

Acta Obstet Gynecol Scand. 2018 Oct;97(10):1200-1205. doi: 10.1111/aogs.13378. Epub 2018 Jun 5.

Abstract

INTRODUCTION

There are limited data on oxycodone pharmacokinetics during pregnancy and on fetal exposure after maternal administration. The present study describes the pharmacokinetics of intravenous (i.v.) oxycodone in pregnant sheep and fetal exposure after intravenous and epidural administration.

MATERIAL AND METHODS

Ten pregnant sheep received 0.1 mg·kg oxycodone intravenously, and blood samples were collected up to 24 hours. Seven days later, the ewes were randomized to receive 0.5 mg·kg oxycodone intravenously (n = 5) or epidurally (n = 5) as a single bolus, before laparotomy for placement of catheters into the fetal superior vena cava and carotid artery. Paired maternal and fetal blood samples were taken when the fetal arterial catheter was in place and at the end of surgery. Maternal blood samples were taken up to 24 hours.

RESULTS

After 0.1 mg·kg oxycodone intravenously, the median clearance was 5.2 L·h ·kg (range 4.6-6.2), but the volume of distribution varied between 1.5 and 4.7 L·kg . The area under the curve was 17 h·ng·mL (range 14-19) and the plasma concentration at 2 minutes 60 ng·mL (range 50-74). Following administration of 0.5 mg·kg intravenously or epidurally, oxycodone concentrations were similar in the maternal and the fetal plasma. Accumulation of oxymorphone in the fetus occurred; fetal-to-maternal ratios were 1.3-3.5 (median 2.1) in the i.v.-group and 0.9-3.0 (1.3) in the Epidural-group.

CONCLUSIONS

We determined the pharmacokinetics of oxycodone in pregnant sheep. We showed accumulation of oxymorphone, which an active metabolite of oxycodone, in the fetus. Further studies in human pregnancies are required to evaluate the safety of oxycodone.

摘要

简介

关于孕妇体内羟考酮的药代动力学和胎儿经母体给药后的暴露情况,相关数据有限。本研究描述了静脉内(i.v.)羟考酮在怀孕绵羊体内的药代动力学,以及静脉内和硬膜外给药后胎儿的暴露情况。

材料和方法

10 只怀孕的绵羊接受了 0.1mg·kg 的羟考酮静脉内给药,采集了长达 24 小时的血样。7 天后,将母羊随机分为静脉内(n=5)或硬膜外(n=5)给予 0.5mg·kg 的羟考酮单次推注,然后进行剖腹术,在胎儿上腔静脉和颈动脉内置入导管。当胎儿动脉导管到位时以及手术结束时,采集配对的母羊和胎儿血样。母羊的血样采集时间长达 24 小时。

结果

静脉内给予 0.1mg·kg 的羟考酮后,中位数清除率为 5.2L·h·kg(范围为 4.6-6.2),但分布容积在 1.5 到 4.7L·kg 之间变化。曲线下面积为 17h·ng·mL(范围为 14-19),2 分钟时的血浆浓度为 60ng·mL(范围为 50-74)。静脉内或硬膜外给予 0.5mg·kg 羟考酮后,母体和胎儿血浆中的羟考酮浓度相似。在胎儿中发现了羟吗啡酮的蓄积;静脉内组的胎儿-母体比值为 1.3-3.5(中位数 2.1),硬膜外组为 0.9-3.0(1.3)。

结论

我们确定了怀孕绵羊体内羟考酮的药代动力学。我们发现了羟考酮的活性代谢物羟吗啡酮在胎儿中的蓄积。需要在人类妊娠中进一步研究,以评估羟考酮的安全性。

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